What cuff pressure range is generally recommended to minimize tracheal injury?

• A. 20-30 cm H2O
• B. 15-25 cm H2O
• C. 30-50 cm H2O
• D. 5-15 cm H2O

Answer: (A)

Maintaining cuff pressure within a narrow window balances sealing the airway with preserving tracheal mucosal blood flow. The commonly recommended range is 20-30 cm H2O. If the pressure is too low, the cuff won’t seal properly, leading to air leaks and possible aspiration. If it’s too high, it compresses the mucosal capillaries, reducing blood flow and increasing the risk of ischemia, ulceration, and tracheal stenosis. Therefore, 20-30 cm H2O is the range that minimizes tracheal injury while still preventing leaks. Pressures well above 30 cm H2O raise injury risk, and pressures well below 20 cm H2O raise leak/aspiration risk. Use a cuff manometer to keep the pressure within this range.